Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana.
BMJ Open. 2021 Jan 17;11(1):e041659. doi: 10.1136/bmjopen-2020-041659.
Identifying hot spots for the overweight aids in effective public health interventions due to the associated public health burden and morbidities. This study, therefore aimed to explore and determine the spatial disparities in the overweight/obesity prevalence among women in Ghana. The study also aims at modelling the average body mass index (BMI) values using the spatial regression and the performance compared with the standard regression model.
This is a cross-sectional study using data from the 2014 Ghana Demographic and Health Survey (GDHS).
The study was set in Ghana.
Data on 4393 non-pregnant women aged 15-49 years from the 2014 GDHS. Both global (Moran's I) and the local indicators for spatial dependence were examined through the mapped BMI values across the country by clusters. An estimated spatial lag model was used to explain the spatial differences in the average body sizes of women.
The overall prevalence of overweight/obesity among reproductive women in Ghana was 35.4%, and this was highly prevalent among educated women (p<0.001), those from wealthy households (p<0.001) and dwelling in an urban setting (p<0.001). Significant clustering (Moran's I=0.3145, p<0.01) of overweight/obesity was observed with hot spots (clustering) in Greater Accra, Central, Western and Ashanti regions. The spatial lag model was the best fit based on the Likelihood ratio test and the Akaike information criterion and Bayesian information criterion values. The mean age of women and household wealth were significant factors accounting for the increase in the average cluster body size (BMI) of women and the spatial differences.
The prevalence of overweight/obesity was high and spatially clustered in the southern, middle and coastal regions. Geographic specific and effective public health interventions and strategies are needed to address the growing morbidity burden associated with the rise in the average body sizes of reproductive women.
由于与超重相关的公共卫生负担和发病率，确定超重艾滋病的热点有助于有效进行公共卫生干预。因此，本研究旨在探索和确定加纳女性超重/肥胖患病率的空间差异。本研究还旨在使用空间回归模型来模拟平均体重指数（BMI）值，并将其与标准回归模型的性能进行比较。
这是一项使用 2014 年加纳人口与健康调查（GDHS）数据的横断面研究。
研究地点在加纳。
来自 2014 年 GDHS 的 4393 名 15-49 岁非孕妇的数据。通过全国范围内 BMI 值的映射图检查了全局（Moran's I）和局部空间依赖指标。使用估计的空间滞后模型来解释女性平均体型的空间差异。
加纳生殖女性超重/肥胖的总体患病率为 35.4%，这在受过教育的女性中（p<0.001）、富裕家庭的女性（p<0.001）和居住在城市环境中的女性（p<0.001）中高度普遍。观察到超重/肥胖存在显著聚类（Moran's I=0.3145，p<0.01），热点（聚类）出现在大阿克拉、中部、西部和阿散蒂地区。基于似然比检验和赤池信息量准则（Akaike information criterion）和贝叶斯信息量准则（Bayesian information criterion）值，空间滞后模型是最佳拟合模型。妇女的平均年龄和家庭财富是导致妇女平均聚类体重（BMI）增加和空间差异的重要因素。
超重/肥胖的患病率很高，且在南部、中部和沿海地区呈空间聚集。需要针对特定地理区域制定有效的公共卫生干预和策略，以应对与生殖女性平均体型增加相关的日益增长的发病负担。
